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Dysmenorrhea in the adolescent Causes and Risks:
Dysmenorrhea in adolescents usually begins 2 to 3 years following the onset of menses. It consists of crampy lower abdominal pain that generally begins several hours prior to the onset of a menstrual period, but may begin as much as 1 or 2 days in advance. The pain lasts one or more days into the period and then subsides. Pain may be mild to severe and may be associated with nausea and vomiting and changes in bowel habits (either constipation or diarrhea ).
Dysmenorrhea is a common gynecological complaint in adolescents but fortunately the majority of cases are functional (not associated with a disease state) and the physical examination is normal. Abnormal conditions associated with dysmenorrhea include endometriosis , pelvic inflammatory disease , vaginal agenesis, and others. Increasing frequency of sexually transmitted diseases among adolescents has increased the percentage of dysmenorrhea cases associated with disease.
Prevention:
There are no specific preventive measures for dysmenorrhea . Avoiding sexually transmitted diseases will decrease disease-associated dysmenorrhea.
Symptoms:
Signs and Tests:
A history and physical examination by the health care provider will differentiate between functional dysmenorrhea and those rare cases associated with a medical condition. Younger adolescents who have not become sexually active usually will not require a pelvic examination.
Treatment:
Initial treatment is focused on relief of pain. Anti-inflammatory medications can be helpful; this includes over-the-counter medications such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (available over-the-counter or in prescription strengths), and prescription-only medications such as indomethacin.
In some severe cases, and with disorders such as endometriosis , oral contraceptives can be helpful. They are used in this case to regulate the hormone levels in the body (they may be prescribed even for girls who are not sexually active).
Prognosis:
Good relief is expected from treatment with mild analgesics . Oral contraceptives generally control severe dysmenorrhea . Dysmenorrhea associated with a disease state responds to treatment of the primary problem.
Complications:
There are no complications from functional dysmenorrhea . Complications may develop from disease-induced dysmenorrhea based on the disease or condition present.
Call Your Healthcare Provider:
If you (or your daughter) experience painful menstrual periods and the pain disrupts your life, occurs frequently, or is not relieved by over-the-counter medications, see your primary health care provider or gynecologist.
This is an illustration of the female reproductive system. Both internal and external views are shown here.
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